Changes in Red Meat Consumption and Risk of Diabetes

Take Note

Increasing red meat intake over 4 years is associated with higher risk of developing type 2 diabetes over the next 4 years, while reducing red meat intake was associated with a lower risk of type 2 diabetes, but only over a longer time period.

Some experts believe that moderate amounts of red meat with low saturated fat content can be part of a balanced, healthy diet.

Identifying specific dietary habits associated with the development of type 2 diabetes mellitus (T2DM) is a public health priority. Several studies have linked baseline red meat consumption to T2DM risk. A person’s dietary habits and the attendant risk of T2DM tend to shift over time, however. This article highlights a recent study that focused on how changes in red meat consumption may be associated with the development of T2DM in the future.1

The investigators analyzed data from approximately 149,000 individuals with up to 20 years of follow-up who were enrolled in 3 Harvard cohort studies: the Health Professionals Follow-up Study, the Nurses’ Health Study, and the Nurses’ Health Study II.1

Red meat consumption was measured with validated food frequency questionnaires every 4 years. Beef, pork, and lamb were considered unprocessed red meat, whereas bacon, hot dogs, sausage, salami, bologna, and similar products were categorized as processed red meat. New cases of T2DM were identified by a validated questionnaire every 2 years.

During nearly 2 million person-years of follow-up, 7540 incident cases of T2DM were identified. Compared with people who did not change their red meat intake over 4 years, those whose intake increased by more than 0.5 servings per day had a 48% higher risk of developing T2DM in the next 4 years (hazard ratio [HR] 1.48; 95% confidence interval [CI] 1.37-1.59). Increases in red meat intake were also associated with weight gain, increases in total caloric intake, and reductions in overall diet quality. Multivariate models were adjusted for baseline red meat intake, demographic characteristics, family history of T2DM, comorbid medical conditions, and concurrent changes in other lifestyle factors. The strength of the association between greater red meat consumption and T2DM was reduced by further adjusting for baseline body mass index (BMI) and concurrent weight gain (HR 1.30; 95% CI 1.21-1.41). A more moderate increase in red meat intake of 0.15 to 0.50 servings per day was associated with a 21% greater risk for T2DM (HR 1.21; 95% CI 1.13-1.30). The association was reduced when adjusting for baseline BMI and concurrent weight gain (HR 1.15; 95% CI 1.07-1.23). Processed red meat was associated with a greater risk for developing T2DM than unprocessed red meat.

While increased red meat consumption over 4 years was associated with T2DM over the subsequent 4 years, reductions in red meat intake were associated with reduced T2DM risk, but only when measured over a longer time period. More specifically, reducing red meat intake by more than 0.5 servings per day over the first 4 years was associated with a 14% reduction in risk (HR 0.86; 95% CI 0.80-0.93) for developing T2DM over the next 12 to 16 years. Again, the association was weaker but still significant, when adjusting for initial BMI and concurrent weight gain (HR 0.90; 95% CI 0.83-0.97).

In an invited commentary published in conjunction with the original article, William J. Evans, PhD, of the Department of Medicine at Duke University, proposed that the color of meat (determined by myoglobin content) may not be the best approach for categorizing health risks and benefits of meat consumption.2 Instead, saturated fatty acid content may be more important. “A recommendation to consume less red meat may help to reduce the epidemic of T2DM,” he wrote. “However, the overwhelming preponderance of molecular, cellular, clinical, and epidemiologic evidence suggests that public health messages should be directed toward the consumption of high-quality protein that is low in total and saturated fat.”

Carol Wolin-Riklin, RD, Metabolic and Bariatric Nutrition Coordinator at the University of Texas Medical School at Houston, does not advise her clients to completely eliminate red meat from their diet. “Not all red meat is created equally,” said Wolin-Riklin. “There are certain cuts that are leaner and lower in saturated fat, and those are the cuts that I tend to recommend, along with cooking techniques to take a leaner, tougher cut and have it serve up really moist and tender.” She stressed moderation, saying, “Nothing in moderate amounts is a bad thing. If you eat too much of a healthy food, it can be just as damaging as a food that is not as healthy. Moderation is the key to a balanced lifestyle and not increasing your risk to develop type 2 diabetes, high cholesterol, high blood pressure.” (For guidance on which cuts of red meat are the leanest, see http://www.mayoclinic.com/health/cuts-of-beef/MY01387.)

In summary, recent research demonstrates a link between increased red meat consumption and development of T2DM, independent of weight gain. However, different types and amounts of red meat may confer different risk profiles.

Evans WJ. Oxygen-carrying proteins in meat and risk of diabetes mellitus: Comment on "Changes in red meat consumption and subsequent risk of type 2 diabetes mellitus: three cohorts of US men and women." JAMA Intern Med. 2013:1-2.

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